title: Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial.
abstract: OBJECTIVE
  To compare the benefits of initiating rehabilitation treatment within 24 hours versus 48-72 hours after total knee arthroplasty for osteoarthritis.
  
  
  METHODS
  Experimental study with clinical trial design.
  
  
  METHODS
  Patients undergoing primary total knee arthroplasty for osteoarthritis were randomly assigned to experimental (n = 153) and control (n = 153) groups.
  
  
  METHODS
  Rehabilitation was started within 24 hours post surgery in the experimental group and between 48 hours and 72 hours post surgery in the controls.
  
  
  METHODS
  Measurement variables included joint range of motion, muscle strength, pain, autonomy, gait and balance.
  
  
  RESULTS
  In comparison with the controls, the experimental group showed significantly shorter hospital stay (by (mean ± standard deviation) 2.09  ±  1.45 days; P < 0.001), fewer rehabilitation sessions until medical discharge (by 4.95  ±  2.34; P < 0.001), lesser pain (by 2.36  ±  2.47 points; P < 0.027), greater joint range of motion in flexion (by 16.29 ± 11.39 degrees; P < 0.012) and extension (by 2.12 ± 3.19; P < 0.035), improved strength in quadriceps (by 0.98 ± 0.54; P < 0.042) and hamstring muscles (by 1.05 ± 0.72; P < 0.041), and higher scores for gait (P < 0.047) and balance (P < 0.045).
  
  
  CONCLUSIONS
  Initiation of rehabilitation within 24 hours after total knee arthroplasty reduces the mean hospital stay and number of sessions required to achieve autonomy and normal gait and balance.
authors.affiliation: Department of Nursing and Physical Therapy, University of Almeria (UAL), Spain.
authors.forename: Nuria Sánchez
authors.initials: NS
authors.lastname: Labraca
authors.forename: Adelaida Maria
authors.initials: AM
authors.lastname: Castro-Sánchez
authors.forename: Guillermo A
authors.initials: GA
authors.lastname: Matarán-Peñarrocha
authors.forename: Manuel
authors.initials: M
authors.lastname: Arroyo-Morales
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Sánchez-Joya
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno-Lorenzo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005684:Gait; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D053580:Muscle Strength; D020370:Osteoarthritis, Knee / Q000601:surgery; D017063:Outcome Assessment, Health Care / Q000379:methods; D010147:Pain Measurement; D004856:Postural Balance; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors